search_index: sfi.db/disclosures, 01589986b00b7a8f9165e09e2f3ae08f204857686c40dd7f5675e0027680f3aa
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| sfi.db/disclosures | 01589986b00b7a8f9165e09e2f3ae08f204857686c40dd7f5675e0027680f3aa | 2018/Pavlos,_Carlene_1.22.18_-_6.pdf | 2018-01-01T00:00:00 | 1 | DISCLOSURE BY NON-ELECTED STATE EMPLOYEE OF FINANCIAL INTEREST AND DETERMINATION BY APPOINTING AUTHORITY RECEIVED AS REQUIRED BY G. L. c. 268A, § 6 STATE ETHICS COMMISSION STATE EMPLOYEE INFORMATION 2018 JAH 22 PH 1: 15 Name: Carlene Pavlos Title or Position: Director, Bureau of Community Health and Prevention State Agency: Massachusetts Department of Public Health Agency Address: 250 Washington Street, 5th Floor, Boston, MA 02108 Office Phone: 617 624 5491 Office E-mail: Carlene.pavlos@state.ma.us My duties require me to participate in a particular matter, and I may not participate because of a financial interest that I am disclosing here. I request a determination from my appointing authority about how I should proceed. PARTICULAR MATTER Particular matter Please describe the particular matter. E.g., a judicial or other I am the Bureau Director for Community Health and Prevention which interacts with the proceeding, application, Massachusetts Public Health Association in a variety of ways. For the purposes of this disclosure, submission, request the most important of these is that we provide MPHA with a contract of approximately $100,000 for a ruling or other through the Preventive Health and Health Services Block Grant. I have been contacted about determination, contract, claim, controversy, applying for the position of Executive Director of the MPHA and will be exploring this opportunity. charge, accusation, arrest, decision, determination, or finding. Your required Please describe the task you are required to perform with respect to the particular matter. participation in the particular matter: As the Bureau Director, I oversee the manager of the Preventive Health and Health E.g., approval, Services Block Grant and the manager who oversees the MPHA contract. I am involved disapproval, decision, in multiple conversations with MPHA staff on a variety of public health issues which recommendation, overlap with the scope of the Bureau and their contract supports public health capacity- rendering advice, building across the state. Should concerns with the current contract arise, I would play a investigation, other. key decision-making role in what actions should be taken by the Department. FINANCIAL INTEREST IN THE PARTICULAR MATTER Write an X by all that apply. I have a financial interest in the matter. My immediate family member has a financial interest in the matter. My business partner has a financial interest in the matter. I am an officer, director, trustee, partner or employee of a business organization, and the business organization has a financial interest in the matter. I am negotiating or have made an arrangement concerning future employment with a person or organization, and the person or organization has a financial interest in the matter. Financial interest Please explain the financial interest and include a dollar amount if you know it. in the matter As previously noted, MPHA is has a contract with DPH's Bureau of Community Health and Prevention and this places me in a position of making key decisions regarding this funding. Their grant award is approximately $100,000 for this fiscal year and is anticipated to be approximately the same next fiscal year. Employee signature: Date: 11/8/17 DETERMINATION BY APPOINTING OFFICIAL APPOINTING AUTHORITY INFORMATION Name of Appointing Authority: Undsey Tucker Title or Position: Associate Commissioner Agency/Department: DPH Agency Address: 250 Wishington St Boston Office Phone: 617.624.5200 Office E-mail lindsey.tncker@stae.ma.us DETERMINATION Determination by As appointing official, as required by G.L. c. 268A, § 6, I have reviewed the particular matter and the appointing authority: financial interest identified above by a state employee. I Write an X am assigning the particular matter to another employee, or by your selection. I am assuming responsibility for the particular matter, or I have determined that the financial interest is not so substantial as to be deemed likely to affect the integrity of the services which the Commonwealth may expect from the employee. Appointing Authority signature: Date: 1/19/18 Comment: Attach additional pages if necessary. File copy with: State Ethics Commission, One Ashburton Place, Room 619, Boston, MA 02108 Form Revised February, 2012 |